Individual provider Active NPI

Kathleen Elizabeth Severeid, DPT

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Tacoma, WA
National Provider Identifier
1063601375
Registry record updated Mar 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X
License
PT00010618 Issued in WA
Practice address
209 M L King Jr Way
TSC-Tacoma Medical Center
Tacoma, WA 98405-4265
Phone
(253) 569-3300
NPI assigned
Oct 23, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X PT00010618 WA Primary

Addresses

Primary practice location

209 M L King Jr Way
TSC-Tacoma Medical Center
Tacoma, WA 98405-4265

Mailing address

PO Box 34584
Seattle, WA 98124-1584
Phone (509) 241-7349

Other names 1

  • Katie Elizabeth Severeid Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130402000259 OR Practitioner - Physical Therapist in Private Practice 6103908330 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chehalem Physical Therapy IncGroup PAC ID 2769455344, 9 clinicians

Practice addresses (Care Compare)

118 N Everest St
Newberg, OR 97132-2102
Phone (503) 538-8952

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Chehalem Physical Therapy, Inc. CurrentSince Mar 9, 2015 Accepting new patients

Locations

118 N Everest St
Newberg, OR 97132
Phone (503) 538-8952

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1193097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205798400000",
    "number": "1063601375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34584",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241584",
            "telephone_number": "509-241-7349",
            "fax_number": "509-241-7628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 M L KING JR WAY",
            "address_2": "TSC-TACOMA MEDICAL CENTER",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054265",
            "telephone_number": "253-569-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEVEREID",
        "first_name": "KATHLEEN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-23",
        "last_updated": "2008-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "WA",
            "license": "PT00010618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATIE",
            "last_name": "SEVEREID",
            "middle_name": "ELIZABETH",
            "credential": "DPT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.